Distraction osteogenesis and its application to the midface and bony orbit in craniosynostosis syndromes
Distraction osteogenesis and its application to the midface and bony orbit in craniosynostosis syndromes
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DOI：
10.1097/00001665-199803000-00003
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发表时间：
1998-03-01
影响因子：
0.9
通讯作者：
Cedars, M
中科院分区：
文献类型：
--
作者：
Toth, BA;Kim, JW;Cedars, M
本研究的目的是证明应用牵引成骨技术来矫正颅缝早闭综合征中的眼眶和面中部发育不全的潜在优势。 15 名患有各种颅缝早闭综合症的儿童接受了 Le Fort III 进阶术，并通过使用一对为每个孩子定制的内部分散装置逐渐分散注意力来辅助。手术过程包括 Le Fort III 截骨术、植入内部装置并在术中开始牵引，以及在接下来的 3 至 5 天内加快中面部前进的速度。牵引硬件的激活是通过经皮销完成的，该销在牵引方案结束时被移除，从而允许内部装置在巩固期间将碎片固定至少 6 个月。随访时间为 3 至 38 个月，平均眼眶和面中部前移为 19.7 毫米（范围：12.0-30.0 毫米）。所有患者的眼球突出均得到减轻，面部比例显着改善。没有遇到严重的并发症。这组患者使用的改良牵引方案旨在满足儿科颅面手术的独特要求，其矫正量几乎是先前报告的传统刚性固定技术的两倍。
The purpose of this study was to demonstrate the potential advantages of applying distraction osteogenesis techniques to the correction of orbital and midfacial hypoplasia in craniosynostosis syndromes. Fifteen children with various craniosynostosis syndromes underwent Le Fort III advancement assisted by gradual distraction utilizing a pair of internal distraction devices custom-fabricated for each child. The surgical procedure consisted of a Le Fort III osteotomy, implantation of internal devices with initiation of distraction intraoperatively, and an accelerated rate of midfacial advancement over the next 3 to 5 days. Activation of the distraction hardware was accomplished by a percutaneous pin, which was removed at the end of the distraction protocol, allowing the internal devices to fixate the fragment for a minimum of 6 months during the period of consolidation. With follow-up ranging between 3 to 38 months, the average orbital and midfacial advancement was 19.7 mm (range, 12.0-30.0 mm). Proptosis was lessened and facial proportions significantly improved in all patients. Serious complications were not encountered. The modified distraction protocol utilized in this group of patients was aimed at addressing the unique requirements of pediatric craniofacial surgery, and resulted in almost twice the amount of correction previously reported for traditional rigid fixation techniques.